# RUSH UNIVERSITY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972630861
- **Authorized official:** DR. MARILYN WIDEMAN RN, DNP (DIRECTOR FACULTY PRACTICE/OUTREACH)
- **Authorized official phone:** (312) 942-7013

## Contact information

- **Practice address:** 730 N PULASKI RD, ROOM 109 ORR SCHOOL BASE HEALTH CENTER, CHICAGO, IL 60624-1063
- **Practice address phone:** (773) 534-8924
- **Practice address fax:** (773) 534-8927
- **Mailing address:** 600 S PAULINA ST, AAF SUITE 1036, CHICAGO, IL 60612-3806
- **Mailing address phone:** (312) 942-5836
- **Mailing address fax:** (312) 942-6226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 209-002424 | IL | Yes |

## Other

- **Enumeration date:** 02/27/2007
- **Last updated:** 07/10/2008